For Use at NCWSs With ONLY Disinfection or No Treatment PWS Name: ID #: Transient System?: Owner Name: (Y/N) Ownership Type: Municipality: County: Service Area: Location Address: Mailing Address (If Different): City/State: , Population Served: PA Zip Code: Number of Connections: * Production (GPD) : Begin Season: Telephone #: ( ) ( ) Number of Meters: Hours Operated/Day: End Season: Laboratory Name: * GPD Gallons Per Day PERSONNEL DATA RESPONSIBLE OFFICIAL Name: Titl.

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How to fill out the PA 3900-FM-BSDW0033 online

This guide aims to assist users in completing the PA 3900-FM-BSDW0033 form, an essential document for public water systems. The following steps will provide clear directions for filling out the form online, ensuring accurate and effective submissions.

Follow the steps to fill out the PA 3900-FM-BSDW0033 form online.

  1. Click the ‘Get Form’ button to retrieve the PA 3900-FM-BSDW0033 form and open it for editing.
  2. Begin with the initial survey date and update information as necessary. Ensure accuracy as this is crucial for tracking and record-keeping.
  3. In the section labeled 'PWS Inventory & Brief Description', fill in your Public Water System (PWS) name and ID number. Indicate whether it is a transient system with a simple yes or no.
  4. Complete the ownership details by entering the owner's name, ownership type, municipality, and county. Provide the service area and location address, ensuring all addresses are correct and current.
  5. List the population served and the number of connections to the system. Include the gallons per day production rate and the operational season details.
  6. Fill out the telephone number sections with clear contact information, ensuring the numbers are accurate and functional.
  7. Provide information regarding the laboratory used and the personnel responsible for the water system. Include their names, titles, and contact addresses.
  8. In the general description/source water information, describe your water system clearly. Attach any necessary sketches and maps as indicated.
  9. For the public water system inventory, fill in sections about sources, treatment plant information, monitoring protocols, and storage facilities.
  10. Complete the certifications at the end of the document. Ensure the responsible official's name, title, and signature are correct.
  11. Finally, review all sections for accuracy. Once completed, save your changes, and download or print the form as needed.

Complete your PA 3900-FM-BSDW0033 form online today to ensure your public water system remains compliant and operational.

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